In Joplin Tornado’s Wake, Local Pharmacists Stepped up to Meet Patient Needs

It’s been almost six weeks since that terrible day in Joplin, Missouri. As Tim Mitchell says, “Life there is consisting of rebuilding slowly.”

But on that Sunday, May 22, when Mitchell learned the extent of the damage from the tornado that struck Joplin, he and his many pharmacist colleagues reacted quickly in springing to action. Mitchell is the owner of two pharmacies and a durable medical equipment business in Neosho, Mo., about 16 miles away.

In the immediate aftermath, Mitchell said that he and Brenna Neumann (a pharmacist on Mitchell’s staff) set up an emergency dispensary that night, only eight hours after the tornado hit in the Health Sciences Building’s first floor break room on the campus of Missouri Southern State University in northwest Joplin. They were joined by Patrick Clay on Monday afternoon. (Clay is associate professor of microbiology and pharmacology in the College of Osteopathic Medicine, and director of clinical research at the Kansas City University of Medicine and Biosciences in Kansas City, Mo. He is also [on a part-time basis] APhA’s science officer.). After Clay’s arrival, and within 24 hours of the tornado, a fully functioning dispensary was up and running.

Because of uncertainties about surrounding pharmacy regulations at the time, Mitchell said the decision was made to function as a dispensary only, with all medicines provided after prescriptions were received by the physicians and nurse practitioners on site only. No outside prescriptions were refilled and for each order received, logs were maintained to record patient name, drug and quantity dispensed. He said that the initial medication source was his pharmacy, but as the day proceeded, samples from various physician offices and pharmaceutical representatives were provided.

Mitchell said most of the patients they saw were those who had been injured as a result of being in the path of the storm.

“These were primarily people needing acute wound care followed by antibiotics and some non-scheduled pain medicines,” he said. “We didn’t consider bringing scheduled drugs in because it was unclear how these would be tracked, or even if a 24-hour pharmacist presence was going to be possible.”

Mitchell said their disaster plan was based on partly on prior experience, but plenty of improvisation was also necessary. Clay had assisted in emergency medicine before, following hurricanes Andrew in 1992 and Katrina in 2005, as well as the1995 Oklahoma City bombing and the 1999 Moore, Okla., tornado.

An executive order signed by Gov. Jay Nixon allowing pharmacists to provide a 30-day medicine supply without first communicating with the provider for that patient helped expedite relief efforts.

“There are requirements for documentation to do this, but this allows a much faster provision for medicines for persons without any ability to obtain their records or find their medicine bottles—let alone their house in many instances,” Mitchell said. After the governor’s order, the board of pharmacy and the Missouri Bureau of Narcotics and Dangerous Drugs helped to clarify what exactly pharmacists and pharmacies—including those not licensed in Missouri—can do.

Mitchell said that what was accomplished in less than 24 hours was “absolutely amazing. It is hard to describe just how incredible it was to have an emergency dispensary/pharmacy established, within the primary medical triage facility, in fewer than eight hours following the actual tornado. Not only did this initial effort materialize out of thin air, additional pharmacists came, provided contact numbers and jumped in for hours or days without ever asking a single question.”

Mitchell said most of his pharmacy staff helped provide assistance, staying fresh by rotating shifts at the dispensary. He also wanted to give credit to other pharmacists who volunteered, including Mike Smith and Joni Forbus from Country Care Pharmacy and Michelle Chapman from Family Pharmacy of Neosho (both owned by Mitchell), and Brian Caswell from Wolkar Drug in Baxter Springs, Kan.

Mitchell is now back in his pharmacy in Neosho, working on his specialty practice and regular medications. As for Joplin, he said that the dispensary was staffed by volunteer pharmacists daily until June 30.

“More pharmacists just continued to show up,” he said. “It has truly been an amazing experience to see the site serve patients in our communities.” Mitchell said that the clinic where the dispensary is located would like to make it a permanent full-time pharmacy soon. “At the moment it is back into the clinic’s hands.”

The road to recovery for Joplin will be long and difficult. To help alleviate some of the hardship, the NCPA Foundation Disaster Relief Fund was established to provide financial assistance to community pharmacy owners for the repair and rebuilding of pharmacies for their recovery in the event of disaster, accidents, illness, or adverse circumstances. Assistance is available to NCPA member and nonmember independent pharmacies—$1,000 per site for NCPA members and $500 per site for nonmembers. Please contact the NCPA Foundation for more information.

Excellent job to Tim and all those involved in the relief effort. My heart goes out to all of the people that have been devestated by the bad weather around the country. You and your fellow pharmacists, doctors, nurses, EMTs, firefighters, law enforcement, etc have truely shown what it means to be a “Professional”. Being a pharmacy owner I have one comment: “What would mail order pharmacy have done?”